A shift in food preferences and a sedentary lifestyle combined to increase the prevalence of cardiovascular diseases in the U.S., according to Hank Cheatham, Vice President, Daiwa Health Development. He reports: “According to a study conducted by the Centers for Disease Control and Prevention (CDC), every year almost 610,000 people die of cardiovascular diseases in the U.S.”
Fortunately, awareness about the benefits of preventative measures is also on the rise. “The growth of the global heart health supplements market can be attributed to the growing number of campaigns being held to spread awareness about the consumption of heart health supplements,” Cheatham says. “Furthermore, the contribution of regulatory authorities and government bodies towards increasing the consumption of heart health supplements is anticipated to drive the growth of the market over the forthcoming years.”
What is the latest need-to-know information in this space? We asked the experts to provide an update for 2024.
Research Focus: Women, COVID, AI & More
There is a shift away from heart tissue and more of a focus on cardiovascular health, says Sid Shastri, M.Sc., Director of Research, Kaneka Nutrients. “The latest research in the heart health space has begun to concentrate on beyond the heart tissue and more on cardiovascular health.” Shastri explains that the cardiovascular system comprises not only the heart (the muscle that pumps the blood throughout the body), but also the blood vessels (which include arteries, veins, and capillaries). “In our reviews, we are seeing exciting new research related to the blood vessels,” he adds, “specifically the endothelial cells, which is the thin, single cell layer membrane that lines all of the vessels.”
Research is also helping to increase our understanding of heart health in women. Anand Swaroop, Ph.D., Founder & President of Cepham, explains, “Cardiovascular disease (CVD) is the biggest killer in females. Most of our ideas about heart disease in women used to come from studying it in men. New research is emerging on the role of hormones that is helping shape the understanding of CVD in women.”
Further, the understanding of the role of cholesterol in heart disease has evolved, Swaroop adds. “Cholesterol levels have long been seen as a risk factor for heart disease. However, recent studies have shown that it may not be the amount of cholesterol in our blood but rather the type and size of particles that contribute to plaque buildup and ultimately increase the risk of heart disease.”
Another research area that has advanced: “Growing research and evidence of the role of COVID on CVD,” says Swaroop. “Multiple mechanisms have been suggested for cardiac damage. Part of the systemic inflammatory response in severe COVID-19 is the release of high levels of cytokines that can injure multiple tissues, including vascular endothelium and cardiac myocytes. The SARSCoV also causes Direct Myocardial Cell Injury, Systemic inflammation, and catecholamine surge.”
Spotlighting another area of growing interest, Swaroop says, “As we continue to learn more about the role of inflammation in our bodies, there has been increasing research on ‘inflammaging’ or chronic low-grade inflammation that occurs as we age. This systemic inflammation has been linked to various age-related diseases, including heart disease. The Th1 cells, part of the adaptive immune response, have been linked to inflammation in the arteries and contribute to plaque formation.”
Technology is also evolving in the heart health space, and that helps patients with personalized healthcare. Swaroop describes, “Use of artificial intelligence (AI) in diagnosing and predicting heart disease has been gaining traction. AI algorithms can analyze vast amounts of health data and identify patterns that may indicate a higher risk for heart disease. This information can then be used to create personalized prevention plans for individuals.”
Emerging Science on Natural Remedies
Many natural ingredients are well-established for their heart-healthy benefits. We asked the experts to spotlight the latest science and emerging ingredients that are leading to innovation in the space. Read on for some of the developments that have the experts excited.
CoQ10 Coenzyme Q10 has long been a standout supplement in the heart health space. Shastri points to more evidence of its benefits: “CoQ10 is essential for mitochondrial synthesis of energy and it can also counter ROS (Reactive Oxygen Species) formation when the CoQ10 is in the ubiquinol form. In addition, ubiquinol has specifically been shown to exert potent anti-inflammatory effects as seen in a genoexpression study involving human immune cells (monocytic cells known as THP-1). As energetic supply is critical for the heart, ubiquinol has shown to be indispensable supporter of cardiovascular health. Furthermore, ubiquinol has shown benefit to the other parts of the cardiovascular system, which is the vascular endothelium.”
Shastri explains that Flow Mediated Dilation (FMD) and Hyperemia Index testing are correlated to vascular fitness of the endothelium. “This single cell layer that covers the vascular wall (‘vascular endothelium’) is the largest organ (by surface area) in the body. Far from being merely a passage-way or a road, the endothelium is a highly active organ that greatly impacts cardiovascular health. The endothelium releases substances that can control vascular relaxation and contraction, secretes nitric oxide for vasodilation, releases various hormones and signaling molecules that contribute to regulation of blood pressure—the vascular endothelium is an amazingly responsive organ.”
Scientists in Japan have been researching how to counter the massive rise in Heart Failure hospitalizations, specifically Heart Failure with reduced Ejection Fraction (HFrEF, and they hypothesized that endothelial dysfunction could be significantly involved," Shastri adds. “Dr. Matsuzawa and team from the Yokohama City University Medical Center presented their research at the ICQA on HFrEF (Heart Failure with reduced Ejection Fraction), also known as systolic heart failure. HFrEF patients commonly deteriorate to poor outcomes and eventually mortality. Heart Failure is a major public medical concern, as it is the most common reason for hospitalization. Dr. Matsuzawa tested the subjects’ endothelial function utilizing reactive hyperemia index—which is a testing methodology based on the same principle as Flow Mediated Dilation.”
The double-blinded, placebo-controlled, cross-over study involved 24 patients. The finding: 400mg per day of ubiquinol demonstrated a clinically meaningful improvement in patents with HFrEF, Shastri reports. The authors noted that “ubiquinol…may be a therapeutic option to treat individuals with Heart Failure with reduced ejection fraction. Furthermore, the study demonstrated 400mg ubiquinol per day for 3 months significantly improved peripheral endothelial function (p= 0.035).” This study is just one of many that Shastri highlights to illustrate the benefits of CoQ10. “Kaneka is committed to furthering the level of science in the field of heart health,” Shastri adds. “And, we are proud to be founding members of the International Coenzyme Q10 Association. Our scientists consider it a core value to improve the health of the community at large. So, we look forward to bringing to you the latest and best options for cardiovascular health!”
Krill Oil. Omega-3s have been a heart health staple for many years, and krill oil is a big part of this conversation, says Cheatham. “Today, krill oil is known for many health benefits, and when it comes to heart health, there is an interesting connection: the liver. Optimal liver health supports the heart in a big way. The liver is connected to a healthy blood system, therefore reducing stress on the heart,” Cheatham says, adding that Daiwa Krill Oil and Daiwa Super Krill Oil powered by Superba Boost are both super antioxidant dietary supplements composed of pure oil derived from Antarctic krill. “Krill oil is the only marine oil that includes a combination of three key substances the human body needs to function properly: omega-3 essential fatty acids (EPA and DHA), phospholipids (an important component of the cell membranes) and antioxidants including astaxanthin (a potent carotenoid that gives krill its red-orange color). Research studies show that krill oil can significantly decrease both diastolic and systolic blood pressure, thereby enhancing cardiovascular health.”
Cashtyn Lovan, Regional Marketing Director, Aker BioMarine, says the most recent human clinical on krill oil and heart health was a major double blind, randomized, placebo-controlled trial with over 500 participants published in JAMA Network Open in 2022. Krill oil was shown to support the heart by:
- Reduced TG levels by 26% at 12 wks (p=.02) and 33.5% at 26 wks (p=.02)
- Increased percentage of subjects to achieve TG levels <500 mgs (p=.02)
- Reduced non-HDL at 26 wks (p=,04)
- Reduced ApoC3 at 26 wks (p=.03)
- Increased EPA/DHA at all study visits (p<.05)
“This publication presents the effects of krill oil supplementation on 520 patients with severely high triglyceride levels in their blood (hypertriglyceridemia),” Lovan explains. “Participants were randomly assigned to receive krill oil capsules or placeboes over the course of the experiment. The patients’ triglyceride levels, plasma omega-3s, and cholesterol levels were measured before, during and after the 26-week duration of the trials. The current publication pools the data from 2 large clinical trials conducted by American and Canadian scientists. This study helps validate the other seven published human clinicals showing krill oil's unique benefits for health heart. This includes studies showing some krill oil advantages over fish oil such as better support for glucose and triglyceride levels and healthy inflammation when compared to fish oil.”
Oleanolic Acid. “The Mediterranean diet has long been touted for its associations with optimal cardiovascular health, powerful antioxidant support, and general longevity and vitality,” says Swaroop. “Speculations abound regarding the reasons for this diet’s demonstrated whole health support. Finally, we have a lab and clinical science that has established one of the components in olive oil as the gem of Mediterranean cuisine.”
Swaroop explains, “If the Mediterranean diet is one of the healthiest options on Earth, then olive oil may be its healthiest ingredient. Honing our focus even further, the most heart-healthy component of olive oil is likely oleanolic acid (OA). OA is found in the highest concentrations in orujo olive oil, the form most commonly used in traditional Mediterranean cooking. OA is a natural antioxidant triterpenoid. While several olive oil components have been researched—including polyphenol hydroxytyrosol and another triterpenoid called erythrodiol —we now know that OA is the most active in the presence of human cells. Even compared to erythrodiol, OA has been found to convey the strongest effects in cardiovascular cells.”
Cepham offers Oleano 85 with 85% OA. “At a typical 100 mg dosage, Oleano 85 provides as much oleanolic acid as 35 tablespoons of high-quality extra virgin olive oil,” Swaroop says. “While olive oil itself is a heart-healthy food, consumers don’t always have the time for complex recipes, and many aren’t fond of the taste. Additionally, olive oil product quality, especially in the U.S., is often compromised. Many brands sell products whose quality is so low, much of the purported olive oil health benefits are negated by the time the consumer purchases the oil. OA supplementation is an effective and convenient solution. Supplemental OA preserves and successfully conveys one of the chief benefits of the Mediterranean diet. In lab and clinical studies, OA has been found to convey vasorelaxant support to human vascular smooth muscle cells.”
Polyphenols. “We know from research in recent years that phytochemicals, such as polyphenols, can make a significant contribution to heart health,” says Andrea Zangara, Head of Scientific Communication and Medical Affairs, Euromed. “The prebiotic and antioxidant properties of polyphenols are recognized for the major role they play in the overall health properties of the Mediterranean diet, which is characterized by a large intake of fruit, vegetables, and olive oil. These natural compounds are a staple of the Mediterranean diet, known for its heart-healthy properties, and are found in fruits and vegetables like pomegranates, olives, artichokes, and lemons—key ingredients in the Mediterranean fruit and vegetable extracts, a line of exclusive ingredients in Euromed's extensive range of premium quality botanicals."
Zangara points to a recently published acute clinical study comparing the bioavailability of Euromed’s Wellemon botanical—a lemon-based, eriocitrin-rich extract—with a hesperidin-rich orange extract. “The results showed that the lemon extract yielded more bioavailable metabolites than hesperidin and may therefore provide more effective health benefits in terms of cardiovascular, metabolic and immune functions. This suggests a potentially more effective role in supporting cardiovascular and metabolic health, leveraging the well-known benefits of citrus flavonoids.”
Another beneficial extract: “One of the most effective heart health ingredients I’ve seen is a patented blend of natural citrus and palm fruit extracts branded Sytrinol,” shares Rob Brewster, President, Ingredients by Nature. “Sytrinol is a proprietary ingredient that combines citrus-derived polymethoxylated flavones (PMFs) with tocotrienols to deliver powerful heart health benefits. A randomized, double-blind, placebo-controlled study on Sytrinol revealed that in as little as four weeks, subjects were able to reduce cholesterol levels by 27%, LDL cholesterol by 25%, and triglyceride levels by 31%. In addition, Sytrinol has two patents for its heart health benefits. The product is also versatile and can be incorporated into various delivery formats to meet the consumer needs of new finished products.”
Brewster points to a 2019 published study in Oxidative Medicine and Cellular Longevity that reviewed recent findings and advances to understand the mechanisms underlying the protective effects of citrus flavonoids. “The summary reported that citrus flavonoids support a healthy heart through their ability to aid in a healthy inflammatory response, reduce oxidative stress, and affect blood lipid parameters. In 2020, another review of flavonoids for heart health confirmed that the botanical extracts play an important role due to their antioxidant properties, healthy inflammatory response, and blood lipid benefits. In 2021, one narrative review also explored the role of flavonoids for heart health and found that they are a favorable ingredient to manage a healthy heart. One clinically studied flavonoid branded Sytrinol is standardized to polymethoxylated flavones (PMFs) with tocotrienols, which may provide its ability to affect blood lipid parameters. PMFs have been shown to inhibit the synthesis of Apo B and triglycerides. Apo B and triglycerides are considered to be the building blocks of LDL cholesterol. On the other hand, tocotrienols have been shown to suppress HMG-CoA reductase. HMG-CoA reductase controls the production of cholesterol.”
Zangara also spotlights Euromed’s pomegranate fruit extract Pomanox, which has been researched for its impact on cardiovascular health and shows promise in optimizing blood pressure. “Recent clinical data indicate that Pomanox may also positively influence satiety and body composition, reducing fat mass and aiding in the maintenance of lean body mass.5 6 This could be partly due to its effect on cortisol levels, which, when unbalanced, can lead to various health issues. Pomanox has shown potential in regulating these levels, contributing to reduced hunger and increased feelings of fullness, thereby aiding in weight management, a vital factor for heart health.”
Also research-backed from Euromed: Pomalive, a combination of standardized olive and pomegranate fruits extracts that could help to improve lipids homeostasis. Zangara says. “This homeostasis is resulting from a balanced distribution of different lipids (triglycerides, total cholesterol, HDL cholesterol and LDL cholesterol), and contributes to primary cardiovascular prevention. This new publication further corroborates cardioprotective effects of combined hydroxytyrosol and punicalagin administration. According to the researchers, the described improvements in the plasma lipid profiles of people with cholesterol imbalances could contribute significantly to the improvement in endothelial function, blood pressure, and LDL cholesterol integrity previously observed with the same combination. Pomalive therefore can provide a holistic approach to heart care, addressing simultaneously multiple components of cardiovascular wellness.”
Probiotics. “Kaneka offers Floradapt Cardio, a three-strain probiotic (L.plantarum KABP-011 to -013), which has high BSH activity,” says Shastri. “Floradapt Cardio deconjugates bile salts into bile acids, thereby increasing the excretion of cholesterol out of the body. This deconjugation activity comes from an enzyme called Bile Salt Hydrolase (BSH), which is produced in maximum amounts by our Floradapt Cardio strains.”
Soy Peptide Enzymes. “Daiwa Health Development has sponsored extensive scientific research on the active ingredient in Plasmanex1, known as Bacillopeptidase F Proprietary Blend (BFPB) and NKCP,” Cheatham says. "The research was conducted on benefits for hypertension, anticoagulant activity & fibrinolytic effects, and thrombolytic activity. There was no negative interaction with warfarin and no toxicity. Plasmanex1 is a dietary supplement. The active ingredient in Plasmanex1 is BFPB, an innovative blend of natural ingredients. The complex contains Bacillopeptidase F, a natural soy peptide enzyme extracted by using a patented fermentation process, (Patent No JP3532503). The enzyme is isolated from natto to form a unique molecule shown in scientific research to support healthy blood circulation, to prevent blood clots, and to improve heart health. Healthy circulation in the vessels can help prevent blood clots. Blood clots can lead to strokes, heart attacks and other myocardial damage.”
Cheatham points out that clinician and internist Fred Pescatore, M.D., MPH, has numerous case studies on Plasmanex1 as a remedy for metabolic disorders and heart health published in the Aug/Sept 2020 issue of the Townsend Letter. “From his research, Dr. Pescatorevconcluded that total cholesterol, LDL cholesterol, and triglycerides were significantly reduced, suggesting that Plasmanex1 possesses lipid-metabolism-improving potential. A significant decrease in HgbA1c was observed, suggesting its potential in diabetes, pre-diabetes, and heart health. A significant decrease in hs-CRP was also observed, suggesting its anti-inflammatory potential. Furthermore, and unexpectedly as a bonus, body weight was substantially reduced, suggesting its body-weight reduction potential. Dr. Pescatore’s scientific studies concluded that Plasmanex1 possesses lipid-metabolism improvement, blood viscosity reduction, anti-diabetes, anti-inflammatory, and body-weight reduction potential and can contribute to improvement of metabolic disorders and metabolic syndrome to include heart health. Plasmanex1 appears to have properties that can contribute to improving heart health and that can contribute to curbing the metabolic markers associated with one’s current lifestyle.”
The Final Word
The demand for heart health supplement products is significantly high as they help in reducing risks related to cardiovascular conditions and diseases, Cheatham says. From omega-3s to fiber-rich and so much more, he says, “the demand for heart health supplements is anticipated to rise extensively over the forthcoming years.” WF
